Are recurrent hyperglycemic episodes and median blood glucose level a prognostic factor for increased morbidity and mortality in premature infants ≤1500 g?

Autor: Heimann, Konrad, Peschgens, Thomas, Kwiecien, Robert, Stanzel, Sven, Hoernchen, Helmut, Merz, Ulrich
Předmět:
Zdroj: Journal of Perinatal Medicine; 2007, Vol. 35 Issue 3, p245-248, 4p, 3 Graphs
Abstrakt: Background: Tight blood glucose control with intravenous insulin reduces morbidity and mortality in adult surgical intensive care patients. This has never been investigated in premature infants weighing ≤1500 g. We investigate the relationship between blood glucose levels repeatedly elevated >150 mg/dL and median blood glucose levels in the first week of life on one hand, and morbidity and mortality in premature infants weighing ≤1500 g on the other. Patients and methods: The following data were collected from 252 premature infants weighing ≤1500 g at birth: demographic data, blood glucose levels at three set times during the day (capillary and arterial) in the first week of life, actual and relative elevation of blood glucose level ≥150 mg/dL, median blood glucose level, allocation of patients into groups according to number of elevated blood glucose levels ≥150 mg/dL (0, 1–3 or ≥4 incidents), and median blood sugar level in relation to mortality and morbidity like IVH, ROP, and sepsis. Results: A significant increase in mortality (P<0.0001) with increasing median blood glucose level and repeated (≥4) incidents of blood glucose levels ≥150 mg/dL and in infants with low gestational age (<27 weeks) were observed . There was no correlation between blood glucose level and morbidity. Conclusion: Premature infants with low gestational age (<27 weeks), elevated median blood glucose levels and/or repeatedly elevated blood glucose levels ≥150 mg/dL have a significantly increased mortality. However, further prospective studies considering the gestational age should determine the relationship between tight glucose control and mortality. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index